Filamentos compósitos de grafeno/poli(ácido lático) para impressão 3D de scaffolds para regeneração de ligamentos

Dissertação de mestrado integrado em Engenharia de PolímerosO ligamento cruzado anterior (LCA) é o ligamento mais frequentemente sujeito a lesões, com difícil recuperação devido à insuficiente vascularização, sendo necessário uma intervenção cirúrgica para recuperar as funções do joelho. As abordagens atuais para o tratamento incluem enxertos, no entanto este tipo de cirurgia apresenta várias limitações tais como a elevada taxa de recorrência e o facto dos tecidos reparados serem mecanicamente inferiores aos tecidos nativos. A engenharia de tecidos pretende resolver estes problemas, produzindo suportes artificiais (scaffolds) para regeneração do LCA em condições laboratoriais, com o potencial de transplante e com uma elevada taxa de sucesso. No presente trabalho foram desenvolvidos filamentos compósitos baseados em poli (ácido lático) (PLA) e em três tipos de reforço: grafite exfoliada (EG), grafite exfoliada funcionalizada (f-EG) e grafite exfoliada funcionalizada com adição de nanopartículas de prata (f-EG + Ag). A funcionalização da grafite foi efetuada através da reação de cicloadição 1,3-dipolar de um ileto de azometina. As nanopartículas de prata (Ag) foram ancoradas na grafite exfoliada funcionalizada, dado crescerem de forma controlada na presença dos grupos funcionais ligados à EG. Os filamentos nanocompósitos foram produzidos por extrusão, usando uma extrusora de duplo fuso co-rotativo. Os filamentos apresentam 1.75 mm de diâmetro, e foram usados posteriormente para o fabrico de scaffolds por impressão 3D, para potencial aplicação na regeneração do LCA. Foram processados diferentes filamentos compósitos: filamento de PLA, filamento de PLA+0,5% EG, filamento de PLA + 0,5% f-EG e filamento com PLA + 0,5% [(f-EG) + Ag]. A morfologia, propriedades térmicas, elétricas e mecânicas de todos os filamentos produzidos foram avaliadas. As propriedades térmicas dos filamentos produzidos foram melhoradas e a dispersão dos reforços na matriz polimérica foi alcançada, de acordo com os resultados obtidos. Não houve alterações significativas das propriedades elétricas e mecânicas dos filamentos com a adição de grafite exfoliada.The anterior cruciate ligament (ACL) is the ligament most frequently injured, with difficult recovery due to insufficient vascularisation, requiring surgical intervention to restore knee function. Current approaches to treatment include grafts, but this type of surgery has several limitations, such as a high recurrence rate and the fact that repaired tissues are mechanically inferior to native tissues. Tissue engineering aims to solve these problems by producing artificial supports (scaffolds) for ACL regeneration under laboratory conditions, with the potential for transplantation and a high success rate. In the present work, composite filaments based on poly (lactic acid) (PLA) and on three types of reinforcement were developed: exfoliated graphite (EG), functionalized exfoliated graphite (f-EG) and functionalized exfoliated graphite with addition of silver nanoparticles (f-EG + Ag). The graphite functionalisation was carried out through the 1,3-dipolar cycloaddition reaction of an azomethine ilet. The silver (Ag) nanoparticles were anchored to the exfoliated functionalised graphite as they grew in a controlled manner in the presence of the EG-bound functional groups. The nanocomposite filaments were produced by extrusion, using a co-rotating twin-screw extruder. The filaments are 1.75 mm in diameter and were subsequently used to fabricate scaffolds by 3D printing for potential application in ACL regeneration. Different composite filaments were processed: PLA filament, PLA+0.5% EG filament, PLA + 0.5% f-EG filament and filament with PLA + 0.5% [(f-EG) + Ag]. The morphology, thermal, electrical and mechanical properties of all the produced filaments were evaluated. The thermal properties of the produced filaments were improved and the dispersion of the reinforcements in the polymeric matrix was achieved, according to the results obtained. There were no significant changes in the electrical and mechanical properties of the filaments with the addition of exfoliated graphite

Um cuidar especializado e promotor da comunicação durante a pandemia COVID-19

O presente documento pretende refletir criticamente o percurso realizado de acordo com as competências comuns e específicas do Enfermeiro Especialista em Enfermagem Médico-Cirúrgica, vertente Pessoa em Situação Crítica, definidas pela Ordem dos Enfermeiros, e as competências de Mestre, baseado no artigo 15º do regime jurídico dos graus e diplomas do ensino superior. Este relatório descreve os objetivos pessoais traçados, as principais atividades desenvolvidas, e os resultados obtidos nos diferentes campos de estágio que decorreram em contexto de Unidade de Cuidados Intensivos e Gabinete Coordenador de Colheita e Transplantação. O trabalho enquadra a prática desenvolvida através da Teoria do Cuidado Humano de Jean Watson. O estágio na Unidade de Cuidados Intensivos permitiu-me cuidar da pessoa em situação crítica e família, enquanto num segundo estágio vivenciei o minucioso processo de transplante. A realização dos estágios decorreu durante a pandemia COVID-19, levando as instituições de saúde a implementarem medidas para prevenir a infeção e promover a segurança do atendimento, aqui num sublinhado à restrição de visitas imposta, com consequente alteração do paradigma da comunicação. As instituições de saúde foram desafiadas a implementar formas para mitigar o isolamento e promover uma comunicação eficaz entre a pessoa adulta internada e família. Perante o cenário de restrições, nasce a inquietação que conduz à questão de investigação: Quais as estratégias promotoras da comunicação, com recurso à tecnologia, entre a pessoa adulta internada e família durante a pandemia COVID-19? Operacionalizada através de uma scoping review. A prossecução dos objetivos delineados permitiu analisar o desenvolvimento de competências ao longo deste percurso formativo, o que contribuiu para a qualidade dos cuidados e a excelência no exercício da profissão, numa prática fundamentada pela investigação, enquanto condição essencial de Mestre em Enfermagem com especialização em Enfermagem Médico – Cirúrgica.This document aims to critically reflect on the course taken according to the common and specific competencies of the Specialist Nurse in Medical-Surgical Nursing, Critical Care Patientscope, as defined by the Ordem dos Enfermeiros, and the competencies of the Master, based on article 15 of the legal framework for higher education degrees and diplomas. This report describes the personal objectives set out, the main activities developed, and the results obtained in the different internship fields that took place in the Intensive Care Unit and in the Coordinator of Collection and Transplantation Office. The work frames the practice developed through Jean Watson's Theory of Human Care. The internship in the Intensive Care Unit allowed me to care for the critically ill person and family, while in a second internship I experienced the meticulous process of transplantation. The internships took place during the COVID-19 pandemic, leading health institutions to implement measures to prevent infection and promote safety of care, therefore emphasizing the restriction of visits imposed, with consequent change in the communication paradigm. Healthcare institutions were challenged to implement ways to mitigate isolation and promote effective communication between the adult inpatient and family. Against this setting of restrictions, the concern that leads to the research question was born: What are the strategies that promote communication, using technology, between the adult inpatient and family during the COVID-19 pandemic? Operationalized through a scoping review. The pursuit of the objectives outlined allowed us to analyze the development of competencies throughout this formative journey, which contributed to the quality of care and excellence in the exercise of the profession, in a practice based on research, as an essential condition for a Master's Degree in Nursing with a specialization in Medical-Surgical Nursing

Ethnic minorities’ and immigrants’ therapeutic (non)adherence: What is the role of social and cultural contexts?

Immigrants and ethnic minorities have been identified as vulnerable groups in health, in general, andin what concerns therapeutic non-adherence (TA) in particular; i.e., (not)following health-careproviders’ therapeutic recommendations. The general aim of this paper is presenting a literature reviewof immigrants’/ethnic minorities’ TA determinants.We will start by highlighting the reasons as to why immigrants’/ethnic minorities’ therapeutic(non)adherence should be a topic of concern. Then, we will present a review of the main determinantsof immigrants’/ethnic minorities’ TA, at different levels of analysis (e.g., broad structural level; socialand community networks; material and social conditions) and emphasize that non-adherence amongimmigrants/ethnic minorities is mostly non-intentional, seeing as how it is associated with issues suchas: low socio-economic conditions, language barriers and cultural mismatches.Finally, we will highlight the role of health-care providers in tackling this health-related problem andreflect about the importance of promoting development and training of health-care providers’multicultural abilities

A qualidade da informação nos serviços : um estudo exploratório do caso português

O reconhecimento de earnings management como um fenómeno-chave da economia atual vem reforçar a importância da qualidade da informação contida nos resultados contabilísticos das empresas. De forma a analisar empiricamente a existência de possíveis padrões e diferentes níveis de qualidade de informação nos diferentes segmentos de atividade económica do setor dos serviços em Portugal, foram utilizadas as medidas dos atributos contabilísticos definidos por Francis et al. (2004): qualidade dos accruals (accrual quality), persistência (persistence), previsibilidade (predictability) e alisamento (Smoothness) que são consideráveis como desejáveis dos resultados nas demonstrações financeiras. No contexto deste estudo exploratório, estes atributos contabilísticos são definidos como proxies da qualidade da informação. A análise empírica recai sobre um período de cinco anos, de 2005 a 2010, e baseiase numa amostra final de 4.863 empresas, repartida em dois grupos comparativos. O primeiro grupo é constituído pelos seis segmentos de atividade económica do setor dos serviços segundo a classificação do Instituto Nacional de Estatística. O segundo grupo é constituído por cinco segmentos de atividade económica do setor dos serviços considerados de risco pela Autoridade Tributária e Aduaneira em 2013. No global, os resultados permitem-nos concluir que diferentes segmentos de atividade económica de um mesmo setor observam diferentes níveis de qualidade da informação

Investigating the photophysical properties and biological efficacy of BODIPY derivatives as photosensitizers in photodynamic therapy

The selectivity of photosensitizers for light activation is a key advantage in photodynamic therapy (PDT), allowing for precise targeting while sparing healthy cells. BODIPY derivatives have emerged as promising PDT candidates due to their tunable photophysical properties and versatile synthesis. Herein, we explore the photophysical characterization and the in vitro photodynamic activity of BODIPY analogues meso-substituted with an anthracene moiety and functionalized with iodine atoms or formyl group at 2,6-position. The formylated anthracene-BODIPY derivative exhibited the highest tumor suppression under irradiation, making it a potential candidate as PDT photosensitizer

Cartilage tissue engineering using electrospun PCL nanofiber meshes and MSCs

Mesenchymal stem cells (MSCs) have been recognized for their ability to differentiate into cells of different tissues such as bone, cartilage, or adipose tissue, and therefore are of great interest for potential therapeutic strategies. Adherent, colony-forming, fibroblastic cells were isolated from human bone marrow aspirates, from patients undergoing knee arthroplasties, and the MSCs phenotype characterized by flow cytometry. Afterward, cells were seeded onto electrospun polycaprolactone nanofiber meshes and cultured in a multichamber flow perfusion bioreactor to determine their ability to produce cartilagineous extracellular matrix. Results indicate that the flow perfusion bioreactor increased the chondrogenic differentiation of hBM-MSCs, as confirmed either by morphological and RT-PCR analysis. Cartilage-related genes such as aggrecan, collagen type II, and Sox9 were expressed. ECM deposition was also detected by histological procedures. Collagen type II was present in the samples, as well as collagen type I. Despite no statistically significant values being obtained for gene expression, the other results support the choice of the bioreactor for this type of culture.M. Alves da Silva would like to acknowledge the Portuguese Foundation for Science and Technology (FCT) for her grant (SFRH/BD/28708/2006). The authors would like to acknowledge the patients of Hospital de S. Marcos, Braga, Portugal, for the donation of the biological samples, as well to its medical staff. The authors would also like to thank the Institute for Health and Life Sciences (ICVS), University of Minho, Braga, Portugal, for allowing the use of their research facilities. Authors would like specially to acknowledge Luis Martins for his valuable help with the histological procedures and Goreti Pinto for the aid in the microscopy. We thank Ana M. Frias for the important help with the FACS procedure. Finally, we would like to acknowledge the European NoE EXPERTISSUES (NMP3-CT-2004-500283). This work was partially supported by the European FP7 Project Find and Bind (NMP4-SL-2009-229292)

Doença inflamatória intestinal com eritema nodoso como manifestação inicial: dois casos clínicos = Inflammatory bowel disease with erythema nodosum as the initial manifestation: two clinical cases

OBJETIVOS: Descrever dois casos de doença inflamatória intestinal cujo diagnóstico foi precedido pelo surgimento de eritema nodoso e alertar para essa manifestação extraintestinal como forma de apresentação inicial da doença. DESCRIÇÃO DOS CASOS: Dois adolescentes de 12 e 15 anos recorreram ao serviço de urgência de Pediatria por eritema nodoso acompanhado de anorexia e perda de peso. Os exames auxiliares de diagnóstico disponíveis foram sugestivos de doença crônica inflamatória e a ecografia abdominal sugestiva de doença inflamatória intestinal. O diagnóstico de doença de Crohn foi confirmado após realização de endoscopia digestiva alta e colonoscopia total com biópsias. CONCLUSÕES: O eritema nodoso pode ser a forma de apresentação de doenças potencialmente graves com terapêuticas bem estabelecidas e implicações prognósticas. Na criança ou adolescente com eritema nodoso o índice de suspeição de doença inflamatória intestinal deve ser elevado, embora devam ser considerados outros diagnósticos diferenciais. A importância do diagnóstico precoce na doença inflamatória intestinal em idade pediátrica consiste na oportunidade terapêutica e nas complicações específicas dessa faixa etária, como déficit de crescimento, que ocorre mais frequentemente na doença de Croh

The U-shaped relationship between parental age and the risk of bipolar disorder in the offspring: A systematic review and meta-analysis

Parenthood age may affect the risk for the development of different psychiatric disorders in the offspring, including bipolar disorder (BD). The present systematic review and meta-analysis aimed to appraise the relationship between paternal age and risk for BD and to explore the eventual relationship between paternal age and age at onset of BD. We searched the MEDLINE, Scopus, Embase, PsycINFO online databases for original studies from inception, up to December 2021. Random-effects meta-analyses were conducted. Sixteen studies participated in the qualitative synthesis, of which k = 14 fetched quantitative data encompassing a total of 13,424,760 participants and 217,089 individuals with BD. Both fathers [adjusted for the age of other parent and socioeconomic status odd ratio - OR = 1.29(95%C.I. = 1.13-1.48)] and mothers aged ≤ 20 years [(OR = 1.23(95%C.I. = 1.14-1.33)] had consistently increased odds of BD diagnosis in their offspring compared to parents aged 25-29 years. Fathers aged ≥ 45 years [adjusted OR = 1.29 (95%C.I. = 1.15-1.46)] and mothers aged 35-39 years [OR = 1.10(95%C.I. = 1.01-1.19)] and 40 years or older [OR = 1.2(95% C.I. = 1.02-1.40)] likewise had inflated odds of BD diagnosis in their offspring compared to parents aged 25-29 years. Early and delayed parenthood are associated with an increased risk of BD in the offspring. Mechanisms underlying this association are largely unknown and may involve a complex interplay between psychosocial, genetic and biological factors, and with different impacts according to sex and age range. Evidence on the association between parental age and illness onset is still tentative but it points towards a possible specific effect of advanced paternal age on early BD-onset

Lithium therapy and weight change in people with bipolar disorder: A systematic review and meta-analysis

Lithium remains the gold standard maintenance treatment for Bipolar Disorder (BD). However, weight gain is a side effect of increasing relevance due to its metabolic implications. We conducted a systematic review and metaanalysis aimed at summarizing evidence on the use of lithium and weight change in BD. We followed the PRISMA methodology, searching Pubmed, Scopus and Web of Science. From 1003 screened references, 20 studies were included in the systematic review and 9 included in the meta-analysis. In line with the studies included in the systematic review, the meta-analysis revealed that weight gain with lithium was not significant, noting a weight increase of 0.462 Kg (p = 0158). A shorter duration of treatment was significantly associated with more weight gain. Compared to placebo, there were no significant differences in weight gain. Weight gain was significantly lower with lithium than with active comparators. This work reveals a low impact of lithium on weight change, especially compared to some of the most widely used active comparators. Our results could impact clinical decisions